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MSF in Colombia, 2010
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In 2010, formally demobilised paramilitary groups re-emerged in many areas across Colombia. The violence in the country prevents many people from accessing healthcare and MSF projects focus on meeting the medical needs of people living in conflict zones or displaced by conflict.
Reaching people in conflict zones
In the north of the country, MSF carried out more than 13,000 consultations in the districts of Sucre and Bolivar that were most affected by violence. MSF also ran mobile clinics in Norte de Santander, carrying out almost 9,000 general consultations as well as consultations on reproductive healthcare.
In Cauca, Putumayo and Nariño, in southwest Colombia, mobile teams visited rural areas that are often the scene of violent conflict and provided general healthcare, as well as reproductive, antenatal and psychological care. In Nariño and Cauca, MSF also assisted in 11 emergencies, providing aid to more than 2,600 displaced people.
In Caquetá, MSF provides mental health services and primary healthcare. Staff managed to reach people living in rural areas of the districts of San Vicente del Caguán and Cartagena del Chairá, who are highly exposed to armed conflict, and where health services are scarce. In total, MSF teams carried out more than 50,777 general medical consultations in Caquetá, Cauca, Nariño and Putumayo.
Mental healthcare is particularly important for people who are exposed to high levels of violence, but it is a service that has been neglected by Colombia’s health system. MSF provided care for more than 12,000 patients in the departments of Caquetá, Cauca, Nariño, Putumayo, Norte de Santander, Sucre and Bolivar. Staff held individual consultations, group consultations and psychosocial support sessions. In 2010, MSF drew attention to mental health needs with its report on Caquetá: Three Times Victims: Victims of Violence, Silence and Neglect, Armed Conflict and Mental Health in the Department of Caquetá, Colombia.The report concluded that there is a significant need for specialised mental health services, and that it is possible to effectively provide good quality mental health services to Colombians caught up in conflict.
Healthcare in Chocó
San Francisco de Asís hospital’s maternity unit, in the town of Quibdó, Chocó department, is the referral centre for all complicated obstetric cases in the department. Since MSF started work in the unit in 2003, it has set up a neonatal ward, trained staff, provided care to victims of sexual violence, and held more than 40,000 consultations. In 2010 MSF handed the project over to a local healthcare provider that has the capacity to take over the activities.
The mobile and fixed clinics along the San Juan River, as well as a boat ambulance, were also handed over. Remote villages along the river will continue to receive healthcare, and MSF staff will continue to operate along the Baudo River.
The MSF clinic in the town of Riosucio, in Chocó department, will continue to provide free healthcare. Staff offer mental health and reproductive health services, and a programme providing medical and psychological assistance to victims of sexual violence. More than 4,400 consultations were carried out in 2010. MSF also supported and provided emergency obstetric care in Riosucio hospital.
Healthcare in Buenaventura
People living in rural areas of Colombia are often forced to choose between living under the threat of violence and taking the risk of giving up everything to move to the city.
Many people displaced by conflict have moved to the Pacific coast. A large number of displaced people have moved to Buenaventura city, in the department of Valle del Cauca. In 2007, MSF set up a health centre providing free consultations to those without any other access to medical care. Staff provided antenatal and postnatal care, vaccinations, emergency services, reproductive healthcare, mental healthcare, treatment for malnutrition and support for victims of sexual violence. Between January and September 2010, 15,520 general consultations were carried out, mainly treating skin and respiratory infections.
In Miramar, a district of the city built on stilts, lack of access to safe water was a significant factor in the incidence of skin and gastric diseases. An MSF team ensured a safe water supply to the residents of the district and, in doing so, repaired more than 700 metres of bridges.
The number of people in Buenaventura suffering from multidrug-resistant tuberculosis is more than three times the national average – Buenaventura is a busy port, and it is likely that the movement of goods and people facilitates the spread of the bacteria. At the end of December 2010, MSF began to support the national tuberculosis control programme with testing and treatment.
Chagas disease in endemic in Colombia, yet detection and treatment programmes are non-existent at the departmental and national levels. MSF’s Chagas programme in Arauca is integrated into the mobile clinics that offer general healthcare. More than 2,750 people were screened, and 34 patients were found to have Chagas in 2010, half of whom had completed treatment by the end of the year (the others are still receiving treatment). There are plans to extend Chagas care to the department of Norte de Santander in 2011.
Relief after the rains
Higher than average rainfall in 2010 led to flooding, which made more than 1.5 million people homeless. MSF participated in the emergency response by providing relief items, including plastic sheeting for temporary shelters, mattresses, blankets and hygiene kits to thousands of displaced people in the departments of Bolivar, Caquetá, Chocó, Nariño and Sucre.
MSF has worked in Colombia since 1985.